One of the issues facing the current session of the Texas Legislature is pitting nurse practitioners against primary care doctors, according to the Texas Tribune. Currently nurse practitioners, who are often the sole source of primary health care for rural and low-income communities, are required to enter into contracts with delegating physicians who have the authority to prescribe medications and approve treatments. The nurses have to pay six-figure fees for this privilege, which places them at a competitive disadvantage and is sending some to seek opportunities out of state, where such arrangements are not required. This is driving up the costs of care at clinics.

One bill, offered by State Rep. Stephanie Klick, R-Fort Worth, would eliminate these arrangements and the fees entirely. But, according to Texas lobbyist and attorney Jake Posey physicians’ groups counter that only they have the expertise to properly treat patients and therefore are complaining to keep these contracts in effect.

The effect of the Klick bill would not include an expansion of what nurse practitioners are allowed to do but would eliminate the huge costs of involving primary care physicians. The House bill and a similar state Senate bill offered by Sen. Kelly Hancock could be a compromise that satisfies both the nurses, who want to lower the cost of health care and doctors, who want to ensure patient safety. The physicians are anxious to maintain a “team approach” to patient care that has been in effect since 2013.

The two bills are backed by a number of groups, including “the AARP, the Texas Association of Business, and the Texas Public Policy Foundation” among other groups, according to the Texas Tribune story.